Intervention Review

Blood pressure lowering efficacy of reserpine for primary hypertension

  1. Sandy D Shamon1,*,
  2. Marco I Perez2

Editorial Group: Cochrane Hypertension Group

Published Online: 7 OCT 2009

Assessed as up-to-date: 11 AUG 2009

DOI: 10.1002/14651858.CD007655.pub2

How to Cite

Shamon SD, Perez MI. Blood pressure lowering efficacy of reserpine for primary hypertension. Cochrane Database of Systematic Reviews 2009, Issue 4. Art. No.: CD007655. DOI: 10.1002/14651858.CD007655.pub2.

Author Information

  1. 1

    University of British Columbia, Faculty of Medicine, Vancouver, BC, Canada

  2. 2

    University of British Columbia, Department of Anesthesiology, Pharmacology and Therapeutics, Vancouver, BC, Canada

*Sandy D Shamon, Faculty of Medicine, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada.

Publication History

  1. Publication Status: New
  2. Published Online: 7 OCT 2009




  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要


Many antihypertensive agents exist today for the treatment of primary hypertension (systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg). Randomised controlled trials have been carried out to investigate the evidence for these agents.There is, for example, strong RCT evidence that thiazides reduce mortality and morbidity. Reserpine has been used as a second-line therapy in some of those trials. However, the dose-related blood pressure reduction with this agent is not known.


To investigate the dose-related effect of reserpine on blood pressure, heart rate and withdrawals due to adverse events.

Search methods

The databases CENTRAL, EMBASE, and MEDLINE were searched. We also traced citations in the reference sections of the retrieved studies.

Selection criteria

Included studies were truly randomised controlled trials comparing reserpine monotherapy to placebo or no treatment in patients with primary hypertension.

Data collection and analysis

Methods of randomization and concealment were assessed. Data on blood pressure reduction, heart rate,and withdrawal due to adverse effects were extracted and analysed.

Main results

Four RCTs (N =237) were found that met the inclusion criteria. The overall pooled effect demonstrates a statistically significant systolic blood pressure (SBP) reduction in patients taking reserpine compared to placebo (WMD -7.92, 95% CI -14.05, -1.78). Due to significant heterogeneity across trials, a significant effect in diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR) could not be found. The SBP effects were achieved with 0.5 mg/day or greater. However, the dose-response pattern could not be determined because of the small number of trials. Data from the trial that investigated Rauwiloid against placebo was not combined with reserpine data from the remaining three trials. This is because Rauwiloid is a different alkaloid extract of the plant Rauwolfia serpentina and the dose used is not comparable to reserpine. None of the included trials reported withdrawals due to adverse effects.

Authors' conclusions

Reserpine is effective in reducing SBP roughly to the same degree as other first-line antihypertensive drugs. However, we could not make definite conclusions regarding the dose-response pattern because of the small number of included trials. More RCTs are needed to assess the effects of reserpine on blood pressure and to determine the dose-related safety profile before the role of this drug in the treatment of primary hypertension can be established.


Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要

Reserpine, an old and almost forgotten antihypertensive drug, lowers blood pressure

Reserpine, a root extract of the naturally occurring plant Rauwolfia serpentina, was used in the past as first-line therapy for reducing blood pressure. Nowadays, it is used mainly as a second line agent. This review, which aimed to find and summarize existing evidence from randomised controlled trials, concluded that reserpine is effective in reducing systolic blood pressure as a first-line agent. The degree of this effect was mild to moderate. Because the four included studies did not investigate a wide range of doses, no data was available to infer a dose-related response in blood pressure. Insufficient data was available to evaluate the adverse effects of reserpine therapy.



  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要













4件のRCT(N=237)が選択基準に適合した。全体的に統合された効果から、プラセボと比較してレセルピン投与患者で収縮期血圧(SBP)が統計学的に有意に低下していた(重み付け平均差-7.92、95%CI -14.05~-1.78)。試験間で有意な異質性があったため、拡張期血圧(DBP)、平均動脈圧(MAP)、心拍数(HR)に対しては有意な効果を見いだすことはできなかった。SBPへの効果は0.5mg/日以上で達成された。しかし試験数が少なかったため、用量反応パターンは明らかにできなかった。Rauwiloidをプラセボと比較検討していた1件の試験からのデータは、そのほかの3件の試験から得たレセルピンのデータと統合しなかった。その理由として、Rauwiloidは植物インドジャボク(Rauwolfia serpentina) からの異なるアルカロイドのエキスであり、使用した用量をレセルピンとは比較できない。含まれた試験はいずれも有害作用による薬剤中止を報告していなかった。




監  訳: 相原 守夫,2010.2.10

実施組織: 厚生労働省委託事業によりMindsが実施した。

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  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要


Reserpine 對原發性高血壓之降壓效果



目標: 為了調查reserpine降低血壓及心率之劑量性相關相關效果,以及劑量與因不良藥物反應而停藥之關係。








四個隨機對照試驗(病人數237人)符合納入標準。在彙總此四研究結果之後,顯示服用reserpine病人收縮壓的降低比安慰劑組有統計學上的意義(加權平均差異(WMD) −7.92, 95%信賴區間−14.05, −1.78)。因為此四組隨機對照試驗間差異性顯著,我們無法得出reserpine比起對照組是否對舒張壓、平均動脈壓、及心率產生統計學上顯著的差異。每天0.5毫克或更大的劑量即可達成對收縮壓的效果。然而,因為這些研究的樣本數太少,我們無法找出劑量性與血壓下降量間的關係。我們也沒有比較Rauwiloid與安慰劑效果組之研究結果併入其他三組研究reserpine的結果。這是因為Rauwiloid是從印度蛇木(Rauwolfia serpentina)萃取出來的一個不同的植物鹼,因此其所使用之劑量無法與reserpine比較。這四組研究均沒有因不良藥物反應而停藥的個案報告。





此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。


Reserpine這個古老且幾乎被遺忘的藥物可以降低血壓。reserpine是植物印度蛇木(Rauwolfia serpentina)根的萃取物。在過去,它被用做第一線的降血壓藥物。而現在,reserpine主要作為第二線降血壓藥。本篇回顧性評論目標在找出並總結現有的隨機對照試驗的證據。我們得出結論:reserpine能有效降低收縮壓,足以擔當第一線降收縮壓藥物,reserpine降收縮壓的程度是輕度到中度的。因為所納入的四組研究並沒有調查大範圍使用劑量,沒有資料可供推論劑量性與血壓下降量間的關係。同時,我們也沒有充分的資料來評估reserpine的副作用。